Doctor Name: | MRS. NICHOLE MELISSA LOPEZ |
NPI Number: | 1023035581 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | F333381 |
Business Practice Address: | 77 N Centre Ave #202 Rockville Centre, NY - 11570 |
Business Phone Number: | 5167647246 |
Business Fax Number: | 5166783525 |
Mailing Address: | 77 N Centre Ave, #202 ROCKVILLE CENTRE |
State: | NY |
Postal Code: | 11570 |
Phone Number: | 5167647246 |
Fax Number: | 5166783525 |
NPI Enumeration Date: | 07/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F333381 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |